Organization Name: | BEA, LLC |
NPI Number: | 1831483734 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEVEN F SHIELDS (BILLING MANAGER) |
Mailing Address: | 5705 Salem Run Blvd Suite 100 Fredericksburg |
State: | VA US |
Postal Code: | 224077119 |
Phone Number: | 5407864882 |
Fax Number: | 5407864893 |
NPI Enumeration Date: | 06/08/2011 |
NPI Last Update Date: | 06/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 0104555602 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |